Going Sane

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What is sanity? What is madness? Perhaps even to try to define
such terms leads us to the futile path that Polonius in
Hamlet warned against when he pondered this question. To
"define true madness", he warned, "what is it but to be anything
else but mad?"

Mad it may be, but the mysteries of unreason, irrationality and
insanity, and equally, of reason, rationality and sanity - however
defined - have preoccupied philosophers, theologians, poets,
writers, as well as psychiatrists and physicians for as long as
humans have inhabited the earth.

What is the dividing line between madness and reason, they have
asked. The early 19th-century British psychiatrist John Haslam
argued at the beginning of his career that reason and madness were
as distinct as black and white, straight and crooked. Later in
life, he confessed that he knew no one who was in his right mind,
"save only the Almighty". Are these categories purely a clinical
disease only to be understood within a medical model, or do they
have a basis within the complex web and intersections of society
and culture?

Centuries ago, doctors made do with simple dichotomies. But
during this past century, psychiatrists have made grander
differentiations between neurosis and psychosis and then within the
latter, a further distinction between manic-depression or bipolar
conditions and schizophrenia.

This simplicity is, of course, deceptive and the energies of
psychiatrists have been to provide finer distinctions between
mental disorders. This has involved providing a set of descriptions
of signs and symptoms such as "compulsions", "phobias", "manias",
"dementia" and so on. Some have argued that this approach has
produced as much chaos as clarification, because mental disorders
are so protean that they seem to resist labelling.

In Going Sane, Phillips addresses not these familiar
questions of what is madness, but rather, explores the condition we
might assume needs no explanation - sanity. In the first part of
this lively and erudite book he argues that the notion of sanity is
not well documented, and is elusive because there has been a
historic aversion to defining it.

In considering how it has been dealt with in a range of literary
and philosophical texts, Phillips concludes that society has never
really found a vocabulary for sanity; there are no films, novels or
television programs about it. "No one is famous for their sanity,"
he observes. "It is difficult to picture sanity because we have no
pictures of it." The sane, he writes, do not capture headline
news.

With an eloquent blend of literary, philosophical and
psychological analysis, Phillips draws on a number of examples such
as "sane" sexuality during adolescence and puberty; the conditions
of autism and schizophrenia; and the relationship between mental
health, money and economics, to consider what a contemporary
account of sanity might look like to us.

This is also a discussion of the use of language and the history
of a word - how it has been invoked and denied and when sanity has
been restored, what people think has happened. Sanity has become a
vocabulary of reassurance.

The wider concerns Phillips raises are profound, astute and
insightful. At times, however, the discussion descends into a
vacuous exercise in semantics. Statements such as: "Sanity meant
not knowing about all the things that might drive you insane were
you to know them" and "the notion of sanity may have been invented
as some fictitious vantage point to observe madness" do not take
the discussion very far. The issue about the absence of
understandings of sanity is laboured to the point of
repetition.

Phillips excels when he considers how the word "sanity" has been
used in various historical, cultural and political contexts.

Invariably, the application of the term has not taken into
account the chaotic parts of the self - it does not allow us to
have a wide and varied reaction to complex situations. Phillips is
thus arguing for an expansion of understanding the term of sanity
to recognise these complexities.

In our contemporary world he tellingly observes, it is no longer
wise to be sane; our culture demands something with more flair,
flamboyance and individuality. The term sounds anachronistic.

While the mad have been pathologised in the past, they have also
been idealised and at times glamorised as well, but the sane have
been either ignored or caricatured, and to be sane is not seen as
complex or idiosyncratic.

Phillips' point here is that the condition of sanity is more
complex than everything that madness is not.

The most valuable and enduring aspect of this book is that in
considering approaches to sanity, however defined, it allows us
also to reflect on a number of wider dimensions - of understandings
of normality and abnormality, imagination and judgement, conformity
and self-assertion, power and oppression and, above all, the
divided self in us all.

Joy Damousi is professor of history at the
University of Melbourne and author of Freud in the Antipodes: A
Cultural History of Psychoanalysis in Australia, published by
UNSW Press.